CD_(14)^+单核细胞人类白细胞DR抗原及C反应蛋白评估脓毒症患者预后的临床价值

Clinical Value of Prognostic Evaluation of CD_(14)^+ Monocyte Human Leukocyte Antigen DR and C-Reactive Protein in Sepsis

目的:评价外周血CD14+单核细胞人类白细胞DR抗原(HLA-DR/CD14+)和C-反应蛋白(CRP)对脓毒症患者预后的判断价值和临床意义。方法:选择入住ICU的脓毒症患者,治疗前测定其外周血HLA-DR/CD14+及CRP、进行APACHEⅡ评分和Marshall评分,观察追踪28天,根据其预后将患者分为存活组和死亡组,分析2组的参数差异,评估参数与患者预后的关系。结果:本研究共入选脓毒症患者21例,12例存活,9例死亡。存活组患者年龄为(65.67±17.15)岁明显低于死亡组的(71.78±8.87)岁(P<0.05);存活组患者HLA-DR/CD14+水平为(28.9±16.1)%明显高于死亡组的(18.7±12.7)%(P<0.05);存活组患者CRP水平为(56.1±18.7)mg/L明显低于死亡组的(91.1±26.3)mg/L(P<0.05)。结论:脓毒症患者的免疫状态与其预后有关,HLA-DR/CD14+和CRP水平对预后判定具有一定的临床价值。

Objective：To investigate the clinical value of CD14＋ monocyte human leukocyte antigen DR（HLA-DR/CD14＋）and C-reactive protein（CRP）on prognosis of patients with sepsis.Methods：Patients with sepsis were enrolled in this clinical trial.According the prognosis,the patients were divided into groups.Flow cytometry application was used to measure the levels of HLA-DR/CD14＋ and CRP was measured at the same time.Results：Twenty-one patients were enrolled into this clinical trial,12 patients were survived and 9 patients were died.In survival group the age（65.67±17.15）was lower than that in death group（71.78±8.87）,P〈0.05.The levels of HLA-DR/CD14＋ in survival group[（28.9±16.1）%]were higher than that in death group[（18.7±12.7）%],P〈0.05.The levels of CRP in survival group[（56.1±18.7）mg/L]were lower than that in death group[（91.1±26.3）mg/L],P〈0.05.Conclusion：HLA-DR/CD14＋ and CRP are valuable in predicting the prognosis of patients with sepsis.